Dr. Marie-Constance Lacasse, a dedicated CAR member and neuroradiologist at McGill University Health Centre (MUHC) has been the acting Radiologist Liaison for patients in Northern Quebec (Nunavik) since 2020. Prior to joining the team at McGill, Dr. Lacasse was working at the University of Sherbrooke for three years, also in neuroradiology. Originally from Montreal, she is happy to be back to her roots at McGill.
In her current role, Dr. Lacasse is responsible for ensuring that patients in Nunavik receive the quality imaging care they deserve. Small community hospitals are located in the two main villages of Puvirnituq and Kuujjuaq. They are run by family physicians, with specialists providing regular on-site and teleradiology services.
The role of the team at these hospitals is to treat and stabilize patients, much of which consists of requisitions for medical imaging. Onsite they have the ability to perform both x-ray and ultrasound. Medical radiation technologists (MRTs) and sonographers perform these procedures. The images are then sent to Dr. Lacasse and her team at McGill directly through their central imaging PACS system. Dr. Lacasse delegates the imaging reads to various subspecialties within the McGill radiology department and ensures that the results are communicated to the referring physician in these Northern facilities. In instances where an exam may be more complex or if an MRT/ sonographer requires support, there is the ability for Dr. Lacasse or one of her team members to connect with the staff to provide live guidance and assistance through teleradiology. This collaboration between the Northern hospitals and McGill provides the capacity for patients in these very remote communities, who have no easy access to larger hospitals, to enhanced diagnostic care. In the event that more advanced imaging is required, the patient will then be mobilized to McGill University Health Centre (MUHC) so that they can receive the care required.
Radiology coverage of Northern Quebec does come with its challenges, the main one being issues with unreliable internet connectivity, hence delaying the transfer of images to the McGill Radiology team. This prevents the team’s current ability to perform efficient emergency radiology, however, projects are in place to improve the system.
The partnership between McGill and the hospitals in Nunavik is gradually improving diagnostic care for patients in these communities as it minimizes the need to move patients to different locations and allows them to receive medical services within their own regions.
“Providing patients in remote locations with rapid diagnostic care without the need to mobilize lets them remain in their own communities and receive treatment and care where they are most comfortable. For non-emergent procedures it reduces the complexity of serving patients, which is better for everyone, says Lacasse.”
There is currently a government approved plan to expand diagnostic imaging services in Nunavik by adding CT scanner to provide more urgent imaging care onsite. Dr. Lacasse is hopeful that this will be sooner rather than later as everyone in the community can benefit from this service.
The pandemic has not had a significant impact on imaging in the North. Some delays were experienced for non-urgent procedures in Northern Quebec due to the initial fear in transferring patients for advanced medical procedures given there was a very low instance of COVID cases in Nunavik. Things have pretty much returned to normal now, however.
During her medical training at McGill University, Dr. Lacasse completed a family medicine rotation in Puvirnituq. This experience provided her with a unique understanding of the many challenges of providing medical care to the remote communities of Northern Quebec compared to radiologists working primarily in urban settings. This knowledge made her a very suitable candidate for this role.
Dr. Lacasse has recently connected with Drs. Reinhold and Reza regarding the MITAC diagnostic imaging work that is taking place in Northern Quebec and will be involved in the project as it rolls out. The objective is to provide optimal medical imaging care to patients in the North.
Dr. Lacasse thoroughly enjoys her role and is looking forward to the opportunity to travel to both Kuujjuaq and Puvirnituq so that she can meet her colleagues in person who are working at these hospitals, once it is safe to do so.